Cranberry juice has lengthy been touted as a pure treatment for stopping and treating urinary tract infections (UTIs). I and different contributors to this weblog have written a number of posts about it over the previous decade. I known as it an alt-med zombie in 2013 and once more in 2016, and right here it’s, again once more in 2025. Through the years, analysis has confirmed combined outcomes, with some research suggesting a possible profit whereas others discovering little to no impact. In comparison with many different various medication therapies, new proof within the type of randomized managed trials proceed to emerge, so I wished to make use of this publish to take a look at the present state of the proof to see if this standard pure product will help scale back the chance of UTIs.
Any people treatment information from the previous 40 years will doubtless point out using cranberries and cranberry juice to forestall or deal with urinary tract infections. It might be used as a complement (as juice, extract, or capsules) to forestall or deal with urinary tract infections (“acute cystitis”). A scientific motive why cranberry would possibly forestall or deal with urinary tract infections continues to be missing regardless of over 5 many years of examine. Is it as a result of the berries are so bitter, that they should be medicinal? An early speculation could have been the flexibility of cranberry to decrease urinary pH, which was thought to assist deal with UTI. Later, an ingredient in cranberry, proanthocyanidins, was thought to dam some variants of E. coli micro organism from adhering to bladder cells, which has been proposed because the mechanism by which it scale back the chance of an infection.
There’s one other important subject with cranberry juice as a drugs: The calorie load. Unsweetened cranberry juice is unpalatable, so it’s normally sweetened. You’d have to eat about 500mL of cranberry cocktail to acquire the everyday quantity studied in medical trials. Two cups of cocktail provides 52 grams of added sugars per day. Over a yr, that’s 41 kilos of added sugar you’re placing in your eating regimen to forestall a urinary tract an infection, except you’re taking a low-calorie model, or capsules. Capsules have been studied (though there may be much less proof than with the juice) and it’s not clear that they’re comparable, although one RCT discovered no distinction. So even when cranberry juice was present to be an efficient remedy, the advantages and harms have to be thought-about fastidiously.
I’ll skip a evaluation of proof to deal with UTIs. Briefly there may be no convincing proof that cranberry juice is helpful as soon as an an infection is current. The proof is extra attention-grabbing for the prevention of UTIs. There have been a number of systematic evaluations over the previous few years which I haven’t blogged about beforehand.
An up to date Cochrane Overview
The biggest systematic evaluation is a Cochrane evaluation (up to date 2023) that included 50 randomized managed trials with 8857 sufferers. And it’s a constructive evaluation – with a bunch of caveats. Forty‐5 research in contrast cranberry merchandise with placebo, water or no particular remedy in six totally different teams of individuals. Twenty‐six of those 45 research could possibly be mixed right into a meta-analysis. The proanthocyanidin content material diverse considerably per dose, from 2.8mg to 118 mg. With average certainty, cranberry merchandise have been estimated to scale back the chance of UTIs by about 30%. When teams have been analyzed, the next was noticed:
- In girls with recurrent UTIs (8 research), the an infection fee was 18% vs. 24% for placebo, which means you’d have to deal with 17 girls for one to learn (NNT=17).
- The was bigger impact in kids with previous UTIs (5 research), the an infection fee was 16% vs. 34% for placebo, giving an NNT of 6.
- In adults following pelvic radiation and surgical procedure, infections charges have been 11% versus 23%, giving NNT of 9.
- No profit was present in institutionalized adults, pregnant girls, or these with intramuscular dysfunction.
There have been no significant variations in antagonistic results between the cranberry and the placebo teams.
There are some cautions to think about when deciphering these outcomes. There seems to be the presence of publication bias in cranberry information, which suggests the efficacy could also be overestimated. As well as, bigger RCTs confirmed a smaller impact in comparison with smaller RCTs.
So are cranberries an affordable various to antibiotics, that are the standard remedy to forestall UTIs in people who expertise recurrent infections? Antibiotics are very efficient, lowering the chance of recurrent UTIs from 66% to about 12% when taken over 6-12 months. Nevertheless, they will trigger unintended effects (15% vs. 8% with placebo) and the consequences on long-term bacterial resistance usually are not nicely studied.
The Berry Backside Line
Probably the most attention-grabbing components of medication is seeing it progress and seeing follow change as proof emerges. Cranberries usually are not a groundbreaking panacea as a medicinal product, however there seems to be one thing there. Recognizing the restrictions of the information, cranberries could be efficient at stopping UTIs. They haven’t been proven to be efficient in everybody, which will increase my skepticism about whether or not these efficacy findings are actual. Having mentioned that, if a affected person with recurrent UTIs (not pregnant, institutionalized or with neuromuscular dysfunction) wished to attempt cranberries as a substitute of antibiotics, I’d be cautiously supportive, noting that cranberries usually are not a slam dunk and is probably not efficient. But when a person was adamant about avoiding every day antibiotics, then cranberries could also be an affordable choice to attempt.